Organization Active NPI

Enrique Rueda PA

  • Surgical Physician Assistant
  • Miami, FL
National Provider Identifier
1407973217
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9101498 Issued in FL
Legal business name
ENRIQUE RUEDA PA
Practice address
9409 Fontainebleau Blvd Apt 101
Miami, FL 33172-5515
Phone
(305) 554-1491
Fax
(305) 554-7154
NPI assigned
Mar 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Enrique J Rueda, PA
Title
PA
Phone
(305) 554-1491

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA9101498 FL
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X PA9101498 FL
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X PA9101498 FL Primary

Addresses

Primary practice location

9409 Fontainebleau Blvd Apt 101
Miami, FL 33172-5515

Mailing address

9409 Fontainebleau Blvd
Apt # 101
Miami, FL 33172-7503
Phone (305) 554-1491

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1407973217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9409 FONTAINEBLEAU BLVD",
            "address_2": "APT # 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331727503",
            "telephone_number": "305-554-1491",
            "fax_number": "305-554-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9409 FONTAINEBLEAU BLVD APT 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331725515",
            "telephone_number": "305-554-1491",
            "fax_number": "305-554-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENRIQUE RUEDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "RUEDA",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PA",
        "authorized_official_telephone_number": "305-554-1491",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101498",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101498",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9101498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.